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General NPI Number Information
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NPI Number | 1740420975
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Entity Type | Individual
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Provider Name | KALYANA C NANDIPATI M.D
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Gender | Male
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Dates
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Enumeration Date | 02/27/2009
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | 2630 E 7TH ST STE 100
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City | CHARLOTTE
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State | NC
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Zip | 28204-4319
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Country | US
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Telephone | 704-355-9484
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Fax | 704-355-3039
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Provider Business Mailing Address
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Address Line | 601 N 30TH ST SUIT 3700
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City | OMAHA
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State | NE
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Zip | 68131-2137
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Country | US
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Telephone | 402-717-4846
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Fax | 402-717-6063
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 26273
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 2024-02564
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License Number State | NC
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